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https://hdl.handle.net/2440/50632
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Type: | Journal article |
Title: | Sex-specific alterations in placental 11 beta-hydroxysteroid dehydrogenase 2 activity and early postnatal clinical course following antenatal betamethasone |
Author: | Stark, M. Wright, I. Clifton, V. |
Citation: | American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 2009; 297(2):R510-R514 |
Publisher: | Amer Physiological Soc |
Issue Date: | 2009 |
ISSN: | 0363-6119 1522-1490 |
Statement of Responsibility: | Michael J. Stark, Ian M. R. Wright, and Vicki L. Clifton |
Abstract: | Placental 11beta-hydroxysteroid dehydrogenase-2 (11betaHSD2) limits fetal glucocorticoid exposure and is associated with physiological stability in the premature newborn infant. Antenatal betamethasone alters 11betaHSD2 activity and confers sex-specific advantages in neonatal outcome. We investigated the influence of betamethasone and sex on 11betaHSD2 activity, neonatal adrenal function and clinical course in 24- to 36-wk gestation neonates from birth to day 5 of life. Univariate analyses demonstrated an interaction between timing of betamethasone exposure and sex for 11betaHSD2 activity rate (P = 0.02) and umbilical arterial cortisol (P = 0.01). For infants born < 72 h following antenatal betamethasone, females had higher 11betaHSD2 activity (P < 0.01) and umbilical arterial cortisol (P = 0.01) than males. Females born < 72 h of betamethasone exposure had higher day 1 urinary cortisol, if exposed to perinatal stress, than males (P < 0.01). For infants born < 72 h after betamethasone exposure, 11betaHSD2 activity was negatively correlated with Clinical Illness Severity Score score (r = -0.79 P = 0.01) and positively correlated with mean arterial blood pressure (r = 0.8 P = 0.01) only in females. Sex-specific placental 11BHSD2 autoregulation following antenatal betamethasone exposure may limit adrenal suppression in females influencing physiological stability following preterm birth. A lack of adjustment in 11betaHSD2 and adrenal response may contribute to the increased incidence of poor outcome observed in preterm males. |
Keywords: | Fetal Blood Placenta Humans Premature Birth Birth Weight Betamethasone Hydrocortisone 11-beta-Hydroxysteroid Dehydrogenase Type 2 Apgar Score Gestational Age Pregnancy Sex Characteristics Blood Pressure Adolescent Adult Infant, Newborn Infant, Premature Female Male Stress, Physiological Young Adult |
Description: | Copyright © 2009 by the American Physiological Society. |
DOI: | 10.1152/ajpregu.00175.2009 |
Published version: | http://dx.doi.org/10.1152/ajpregu.00175.2009 |
Appears in Collections: | Aurora harvest 5 Obstetrics and Gynaecology publications |
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